前沿进展丨抗aPS/PT抗体与血栓事件显著相关并助诊抗磷脂综合征

点击上方“天道医药”关注我们

目的：评估磷脂酰丝氨酸依赖的抗凝血酶原抗体（aPS/PT）在抗磷脂综合征（APS）中的诊断意义，并明确aPS/PT阳性的APS患者的临床特点。

方法：收集108个APS患者的血清作为研究对象，60个有妊娠并发症的患者、37个有血栓病史而没有明确的自身免疫性疾病病史的患者和89个健康志愿者作为对照组。应用ELLISA方法在同一样本中检测aPS/PT，包括IgG/M，IgG和IgM亚型。应用卡方检验比较此抗体在APS及其他免疫疾病患者体内的阳性率。应用Spearman 相关分析明确aPS/PT与其他临床及实验室指标之间的相关性。108个APS患者中有68人（63%）检测出aPS/PT，91个疾病对照人群中有12人（13.2%）检测阳性，健康对照组中有1人（1.1%）检测阳性。aPS/PT与LA活性强相关(OR 15.952, 95% CI 7.132-35.678; P < 0.001)。56.9%的抗心磷脂抗体阴性患者、60.5%的抗β2GP1抗体阴性的患者以及50.5%抗心磷脂抗体及抗β2GP1抗体均阴性的患者中aPS/PT阳性。IgG型aPS/PT与动脉及静脉血栓显著相关。

结论：aPS/PT在APS患者中与血栓事件正相关。aPS/PT抗体在APS的诊断，尤其是抗心磷脂抗体阴性、抗β2GP1抗体阴性的的APS患者的诊断中有着非常重要的作用。

附原文：Abstract To evaluate the diagnosis value of antibodies to phosphatidylserine/prothrombin complex (aPS/PT) in patients with antiphospholipid syndrome (APS) and to determine the clinical features of APS patients with avidity of aPS/PT. Serum samples were collected from 108 APS patients. Sixty patients with pregnancy morbidity, 37 patients with thrombosis without a history of autoimmune diseases, and 89 healthy blood donors were included as the control group. The enzyme-linked immunosorbent assay (ELISA) test was performed to detect the concentration of aPS/PT, including IgG/M, IgG, and IgM forms, in the same serum sample. The chi-square (χ2) test was used to examine the difference of frequencies of antibodies in APS patients and patients with other diseases. Spearman correlation analysis was performed to investigate the relationship between aPS/PT and other clinical/laboratory parameters. aPS/PT was detectable in 68 (63.0%) of the 108 APS patients, 12 (13.2%) of the 91 disease control patients and 1 (1.1%) of the healthy controls. It was strongly correlated with the activity of lupus anticoagulant (LA) (OR 15.952, 95% CI 7.132-35.678; P < 0.001). The frequency of aPS/PT was 56.9% in anti-cardiolipid antibody (aCL)-negative, 60.5% anti-β2 glycoprotein I antibody (aβ2GPI)-negative, and 50.0% in both aCL and aβ2GPI negative APS patients. The IgG aPS/PT was significantly associated with arterial and venous thrombosis. The aPS/PT antibody could play an important role in the diagnosis of APS, especially in patients with negative aCL and aβ2GPI. It was positively related to thrombotic events in APS.

Zhu L

et al.Diagnostic value of antibodies to phosphatidylserine/prothrombin complex for antiphospholipid syndrome in Chinese patients.

Clin Rheumatol.

 2017 Feb;36(2):401-406. doi: 10.1007/s10067-016-3498-0. Epub 2017 Jan 3.

深圳市天道医药有限公司生产的依诺肝素制剂已获得欧盟药政批准并取得正式批准文件，是欧盟市场获批的第一个依诺肝素的仿制药。